Provider Demographics
NPI:1063097392
Name:GABUYA, EMIL EUGENE FRANZ
Entity type:Individual
Prefix:
First Name:EMIL EUGENE FRANZ
Middle Name:
Last Name:GABUYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 CHALMERS BLVD
Mailing Address - Street 2:
Mailing Address - City:AMAWALK
Mailing Address - State:NY
Mailing Address - Zip Code:10501-1216
Mailing Address - Country:US
Mailing Address - Phone:818-384-2098
Mailing Address - Fax:
Practice Address - Street 1:22 HOSPITAL AVE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5945
Practice Address - Country:US
Practice Address - Phone:203-312-7910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2021-04-07
Deactivation Date:2021-03-17
Deactivation Code:
Reactivation Date:2021-04-07
Provider Licenses
StateLicense IDTaxonomies
CT125862251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty